Cerebral Blood Flow Monitoring in High-Risk Fetal and Neonatal Populations.

Cerebral Blood Flow Monitoring in High-Risk Fetal and Neonatal Populations.
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DOI:
10.3389/fped.2021.748345
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发表时间:
2021
影响因子:
2.6
通讯作者:
Chalak LF
Chalak LF
中科院分区:
医学3区
文献类型:
--
作者:
Leon RL;Ortigoza EB;Ali N;Angelis D;Wolovits JS;Chalak LF

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脑血管压力自动调节可促进不同动脉血压范围内脑血流量 (CBF) 的稳定。大脑自动调节(CA)是一个发育过程,在足月妊娠时达到成熟,可以通过多普勒超声和磁共振成像(MRI)技术进行产前监测。产后,使用多普勒超声、MRI 和近红外光谱评估 CA 有关键的优点和局限性。在这里,我们回顾这些 CBF 监测技术以及它们在有 CBF 扰动风险的胎儿和新生儿群体中的应用。具体来说,我们讨论了宫内生长受限、贫血、先天性心脏病、早产新生儿和缺氧缺血性脑病胎儿的 CBF 监测。我们在回顾中总结了该领域的未来方向,重点是协作科学和精准医学方法。
Cerebrovascular pressure autoregulation promotes stable cerebral blood flow (CBF) across a range of arterial blood pressures. Cerebral autoregulation (CA) is a developmental process that reaches maturity around term gestation and can be monitored prenatally with both Doppler ultrasound and magnetic resonance imaging (MRI) techniques. Postnatally, there are key advantages and limitations to assessing CA with Doppler ultrasound, MRI, and near-infrared spectroscopy. Here we review these CBF monitoring techniques as well as their application to both fetal and neonatal populations at risk of perturbations in CBF. Specifically, we discuss CBF monitoring in fetuses with intrauterine growth restriction, anemia, congenital heart disease, neonates born preterm and those with hypoxic-ischemic encephalopathy. We conclude the review with insights into the future directions in this field with an emphasis on collaborative science and precision medicine approaches.
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